Provider Demographics
NPI:1881776508
Name:FLOYD COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:FLOYD COUNTY HEALTH DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DISTRICT HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:W
Authorized Official - Last Name:SELLERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-295-6704
Mailing Address - Street 1:16 E 12TH ST SW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-4720
Mailing Address - Country:US
Mailing Address - Phone:706-295-6123
Mailing Address - Fax:706-802-5445
Practice Address - Street 1:16 E 12TH ST SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-4720
Practice Address - Country:US
Practice Address - Phone:706-295-6123
Practice Address - Fax:706-802-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or Welfare
No251X00000XAgenciesSupports BrokerageGroup - Single Specialty
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000699234DMedicaid
GA000051829FMedicaid
GA000457751FMedicaid
GA000619605CMedicaid
GA000699234AMedicaid
GA202G736699Medicare PIN